Pittsburgh Clinical Center (PCC) is a clinical-translational program at the University of Pittsburgh and UPMC designed to conduct studies on recurrent acute pancreatitis (RAP) and chronic pancreatitis (CP) and factors that increase the risk of fibrosis, pain, and pancreatogenic diabetes (T3cDM) in children and adults, and risk of pancreatic ductal adenocarcinoma (PDAC) in adults with CP and/or DM. Multi-disciplinary teams at the University of Pittsburgh and UPMC are organized to participate in comprehensive clinical, epidemiological and biological characterization of patients with pancreatic disorders and to define the pathophysiology of RAP & CP and their sequela. Three specific aims are proposed: Aim 1. To develop integrated clinical center core processes to facilitate data and biosample management, to maximize communication and to evaluate of new technologies. Aim 2. To establish a model longitudinal research cohort of patients during evolution of definite CP. Aim 3. To generate and test a framework to analyze risk factors affecting the progression of RAP, probable CP and definite CP, and clinically useful biomarkers to monitor disease state and endpoints. Our existing and well-established, efficient and effective clinical infrastructure for patient accrual, sample processing, disease progression assessment, data management and analysis will support the program. The rich clinical volume, expert physician phenotypers in all critical areas, established leadership in epidemiology, genetics, physiology, cell biology, imaging, biostatistics and bioinformatics, and all relevant disease subtypes, plus administrative authority in clinical and research areas for both the adult and children ensure continued success. The history of strong collaborations and working relationships of the PCC faculty with many outstanding programs at other universities will also provide momentum to the national consortium.